Feeding can be one of the most satisfying activities involved with caring for a child. Conversely, it also can be the most frustrating. From infancy, food acceptance is exclusively under a child’s control, at times much to the frustration of the child’s caregivers. 

 

Fussy eating, generally defined as “consuming a limited variety of food” is a very common problem in young children. Up to 20% of infants and toddlers in the UK are reported to be “problem” eaters by their parents with some studies reporting up to 50% are fussy eaters. 

 

Feeding difficulties refers to a spectrum of problematic eating behaviours such as excessive spitting out of food, crying/irritability at feeding time, eating extremely slowly, retching at the sight of bottle or spoon, apparent difficulty in swallowing, throwing and pushing away food (Crist & Napier-20 Phillips, 2001; Lewinsohn et al., 2005). 

 

Child feeding difficulties and food allergies

 

There is a now an increasing recognition of food allergy as yet another condition associated with feeding disorders. In a young child with suspected or confirmed food allergy, where at least one food group is already being restricted, fussy eating and feeding difficulties are likely to have a considerable impact on eating habits and food intake. Children who have experienced frightening food allergic reactions and/or unpleasant symptoms such as vomiting can become scared about eating. Children develop their feeding skills by watching and practice. For a child with food allergies it may not be possible to introduce as wider variety of tastes and textures and therefore they may not learn to like as wider variety of foods. 

 

Factors involved in fussy eaters

 

• Mealtime environment is a significant factor particularly if stressful or ‘overwhelming.’ 
• Sensory sensitivity e.g. some children have an increased awareness of smells, tastes, textures, noises. 
• Some children have a more rigid thinking style e.g. they like routine, sameness and predictability and find ‘change’ more difficult. 
• Children with feeding difficulties may have a stronger ‘neophobic’ response (a natural fear of anything new) to food.  
• Anxiety also plays a significant role in food refusal. Some children may exhibit food refusal based on fear related to previous uncomfortable or painful experiences. Such anxiety may serve as another reinforcer for inflexibility and food refusal in some children.

 

Children with feeding difficulties often have a preference for:

 

• Sweeter, salty tasting foods
• Certain textures of foods e.g. smooth puree/crisp and dry foods
• Foods identified by certain packaging/brands
• Beiger/brown coloured foods 
• Plain foods e.g. no sauce or food to be separated on plate

 

How can psychology help?

 

Helping your child to build positive associations with food and eating is an important (and often challenging) job for any caregiver. Many children will go through tricky phases with their eating habits too. The psychologist will aim to understand the different factors involved in the child’s eating behaviour such as difficulty weaning, physical health (like food allergies), anxiety, stress around mealtimes, neurodiversity and sensory sensitivities. The psychologist will assess, formulate and treat the psychological issues which may be causing the disordered eating behaviour which may mean focusing on a variety of different aspects of the child’s life.

 

Top tips for happier mealtimes

 

Keep mealtimes as relaxed as possible

The main meal should not be longer than 30 minutes

Try to eat together as a family where possible

Create a visual planner for mealtimes so you child knows in advance what is being offered

Allow your child to self-feed (if developmentally appropriate)

Plan something enjoyable for after the meal e.g. story/game/video

You can offer a choice between 2 foods e.g. ‘would you like toast or Weetabix for breakfast?

 

Messy play and food play

 

• Start with activities using dry foods or allow you child to use utensils. Move onto wetter/sticky textures when your child is ready
• Try to do twice each week for 10-15 minutes
• It should be fun with no expectation to eat the food and no pressure
• Your child will be aware of your reactions to these foods so it important to model being relaxed and enjoying the exercise

 

Tasting Times

 

• Choose 2-3 new foods 
• Introduce these foods away from meal times in tiny portions
• Allow your child to explore the sensory properties of the food starting by looking/smelling the food and working toward touching, licking ect
• There is no pressure on the child to eat the food
• You can give a non food reward when a certain level is reached

 

Get in touch for help with fussy eating:

 

Dr Polly James has extensive experience working with children with a range of psychological difficulties. She works from our Eastbourne & Hove clinics. Please contact us to arrange an initial consultation.